How much rates vary
Facilitymedian $186 · 10th to 90th $141 to $490Professionalmedian $98 · 10th to 90th $69 to $195
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $302.00 | Facility | None | $97.72 | $97.72 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $97.72 | Professional | None | $77.62 | $97.72 | $97.72 |
AllWays Health Partners Setting Facility Modifier None Typical Low $144.54 Median $154.88 Typical High $501.19 | Facility | None | $144.54 | $154.88 | $501.19 |
AllWays Health Partners Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $891.25 | Professional | None | $75.86 | $125.89 | $891.25 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $169.82 Median $199.53 Typical High $263.03 | Facility | None | $169.82 | $199.53 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $69.18 Median $131.83 Typical High $131.83 | Professional | None | $69.18 | $131.83 | $131.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $144.54 Median $154.88 Typical High $501.19 | Facility | None | $144.54 | $154.88 | $501.19 |
Mass General Brigham Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $891.25 | Professional | None | $75.86 | $125.89 | $891.25 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
United Setting Professional Modifier None Typical Low $50.12 Median $75.86 Typical High $93.33 | Professional | None | $50.12 | $75.86 | $93.33 |
Well Sense Setting Facility Modifier None Typical Low $107.15 Median $147.91 Typical High $223.87 | Facility | None | $107.15 | $147.91 | $223.87 |
Well Sense Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $208.93 | Professional | None | $91.20 | $91.20 | $208.93 |
7 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $38.90 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $15.49 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $11.75 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.76 | $9.55 | $9.55 |
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where Massachusetts sits
The same service costs 2.4 times more in Montana than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Massachusetts· 33rd of 51
$97.72
MT $155UT $64.57
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.